EFFECTS OF CALCIUM AND VITAMIN D SUPPLEMENTATION ON CRYPT MORPHOLOGY IN NORMAL COLON MUCOSA Open Access

Abstract

To investigate the effects of calcium and vitamin D on crypt morphology (length,
perimeter, and area of crypts) in the normal colorectal mucosa of sporadic colorectal
adenoma patients, we conducted a pilot, randomized, double-blind, placebo-controlled
2×2 factorial chemoprevention clinical trial of supplemental calcium 2,000 mg/day and
vitamin D3 800 IU/day, alone and in combination, versus placebo over 6 months.
Colorectal crypt length, perimeter, and area in the normal-appearing rectal mucosa were
quantified by image analysis. The mean crypt length increased by 1% (p=0.92) in the
calcium group, and decreased by 2% (P = 0.69) and 4% (P = 0.40) in the vitamin D and
calcium plus vitamin D groups, respectively, relative to the placebo group. The mean
crypt perimeter decreased by 2% (P = 0.70) and 4% (P = 0.40) in the vitamin D and
calcium plus vitamin D groups, respectively, relative to the placebo group, but did not
change appreciably in the calcium group. The mean crypt area decreased by 2% (P =
0.74), 5% (P = 0.41) and 7% (P = 0.30) in the calcium, vitamin D and calcium plus
vitamin D groups, respectively, relative to the placebo group. These results indicate that
calcium and/or vitamin D3 supplementation does not change the crypt morphology
(length, perimeter, and area of crypts) in the normal human colorectal epithelium of
sporadic adenoma patients.

Table of Contents

TABLE OF CONTENTS

CHAPTER I..............................................................................................1
Descriptive Epidemiology..........................................................................1
Colorectal Carcinogenesis.........................................................................2
Environmental Factors in Colorectal Cancer ................................................3
Calcium, Vitamin D, and Colorectal Cancer Risk.............................................4
Surrogate End-Point Biomarkers (SEBs) in Colorectal Cancer...........................8
Crypt Morphology and Colorectal Cancer.....................................................9
CHAPTER II.............................................................................................12
ABSTRACT............................................................................................12
INTRODUCTION......................................................................................13
METHODS.............................................................................................14
RESULTS..............................................................................................19
DISCUSSION..........................................................................................21
CHAPTER III............................................................................................26
REFERENCES............................................................................................27
TABLES AND FIGURES................................................................................33
APPENDIX...............................................................................................39

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	clinical trial crypt length colorectal cancer crypt morphology calcium vitamin D
Committee Chair / Thesis Advisor	Bostick, Roberd M, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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